Ankle fractures are the most common type of fractures treated by orthopedic surgeons. The prevalence of such fractures has increased over the last two decades in both young, active patients and the elderly people. [1,2] Most ankle fractures are complex injuries that are difficult to manage. These injuries are of utmost importance as the Background: The movement around ankle joint is very important because of the cultural practices, which involve squatting and sitting cross-legged. Bimalleolar Pott's fractures are very common in ankle joint injuries because of increased incidence of road traffic accidents and industrial trauma. Accurate reduction of fractures around ankle joint is important for a painless ankle joint. Objective: To study the functional outcome of surgically managed closed bimalleolar fractures of ankle in adults; to evaluate restoration of the anatomy of malleoli and ankle perfectly by operative treatment with internal fixation; to assess the union of fractures after surgical management; and to achieve stable fixation and early mobilization of the ankle. Materials and Methods: We have evaluated clinical, radiographic, and functional outcomes of 40 patients treated with a combination of different treatment modalities, which involve the combination of tension band wiring (TBW), Kirschner (K)-wire, Rush pin, cortical and cancellous screws, and one-third tubular plates for lateral and medial malleolus fixation. Results: In this prospective study, 40 cases of bimalleolar fractures of ankle were treated by surgical methods. Road traffic accident was the most common mode of injury. Majority [16 (40%)] of the cases showed supination-external rotation injury, followed by 11 (27.5%) cases with pronation-external rotation injury. Majority [29 (72.5%)] of the medial malleolus fractures were fixed with TBW. In the remaining cases, cancellous screws and K-wire were used. Most [20 (50%)] of the lateral malleolar fractures were fixed with K-wire. In the rest of the cases, one-third tubular plate and Rush pin were used. In our study, the average time taken for union was 10.4 weeks. Excellent results were achieved in 23 cases (57.5%), good in 10 cases (25%), fair in five cases (12.5%), and poor in two cases (5%). Excellent results were observed in most bimalleolar fractures. Of the two cases with poor results, one developed superficial infection and the other showed delayed union. Conclusion: Unstable bimalleolar ankle fractures are common because of road traffic accidents. Understanding the mechanism of injury is essential for anatomical reduction and fixation. Fibular alignment (length and rotation) has to be maintained for lateral stability of the ankle. Anatomical reduction with restoration of the articular congruence is essential in all intra-articular fractures, more so, if a weight-bearing joint such as ankle is involved. Open reduction and internal fixation restores the articular congruity of the ankle joint. Excellent results are obtained with stable fixation of fracture. TBW is better in internal fixation...

Open reduction and internal fixation with precontoured distal humerus anatomical locking plate system is a good method of treatment for complex Supra- intercondylar fracture of distal humerus with good functional outcome and low rates of complications. Even though early results are promising, longer term investigations and larger patient groups are necessary to confirm the presented data.

Objective: The objective of the study was to assess the outcome of Salter- Harris type III distal radius fracture fixed using the principle of buttressing and avoiding screw insertion through the physis.Materials and Method: Eight school going children in the age group of 11-16 years with volar Barton fractures were treated with a volar plate using the buttress principle without inserting screws in the distal fragment. Patients were evaluated over a period of 18 months. Clinical evaluation was done using the Green O’Brien criteria and radiological evaluation using the Sarmiento criteria.Results: The average union time was two months. All the patients had good to excellent functional outcome with full extension and flexion.Conclusion: Buttress plating of volar Barton fractures in the adolescent age group is an excellent technique to achieve satisfactory outcome without violation of the physis.

Posterior dislocation of shoulder is relatively uncommon entity. Posterior fracture dislocation of shoulder is even rare and bilateral posterior fracture dislocation of shoulder is even rarest entity. We present a case of 45 years of adult male having bilateral posterior fracture dislocation of shoulder following convulsive seizure and treated with open reduction and internal fi xation with satisfactory functional outcome.